MEDICARE: ERIC CHAPA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	G33747	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	756083107	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851395131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC CHAPA M.D.

Provider Business Mailing Address
First Line	:	5040 E MORADA LN
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95212-2410
Country	:	US
Telephone Number	:	209-601-8881
Fax Number	:	209-931-4850

Provider Business Practice Location Address
First Line	:	5040 E MORADA LN
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95212
Country	:	US
Telephone Number	:	209-601-8881
Fax Number	:	209-931-4850

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	08/06/2018

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